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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Clin+Med+Insights+Case+Rep 2016 ; 9 (ä): 21-4 Nephropedia Template TP
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Tubulointerstitial Nephritis and Uveitis Syndrome: Are Drugs Offenders or Bystanders? #MMPMID26997878
Kawamata M; Akimoto T; Sugase T; Otani-Takei N; Miki T; Masuda T; Kobayashi T; Takeda Si; Muto S; Nagata D
Clin Med Insights Case Rep 2016[]; 9 (ä): 21-4 PMID26997878show ga
A 16-year-old female patient was admitted to our hospital due to progressive renal dysfunction with an increased serum creatinine (sCr) level of 1.7 mg/dL. Her clinical course without any ocular manifestations and results of drug-induced, lymphocyte-stimulating tests, in addition to a renal histological assessment, initially encouraged us to ascribe the patient?s renal abnormalities to drug-induced acute interstitial nephritis (AIN). Four months later, she started to complain about reduced visual acuity when she was found to have anterior bilateral uveitis despite the recovered renal function with almost constant sCr levels around 0.7 mg/dL. Thus, a diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was finally made. Our case illustrates the difficulties in distinguishing late-onset uveitis TINU syndrome from drug-induced AIN at the time of the renal biopsy, thereby suggesting the importance of a longitudinal follow-up to overcome the potential underdiagnosis of the disease. Several diagnostic conundrums that emerged in this case are also discussed.